The Valley as worst-case laboratory

The Central San Joaquin Valley is where researchers come to paint often worst-case health scenarios for the rest of the nation. But when it comes to triggering remedies, along with the necessary political, fiscal and educational muscle, there are few who’ll take leadership. A flood of recent surveys and studies has reminded Valley residents that the air they breathe, the water they consume and the neighborhoods they call home are among the most befouled in the state and nation.

Not exactly “reason to live here” stories, especially when piled atop other unhealthy trends -- the lack of skilled mental health professionals, inpatient psychiatric beds, inpatient acute care beds and regional transit to get from rural need to urban care. One reputable storehouse of these dark tidings is the website of California HealthCare Foundation. It recently reported:

The number of physicians in the Valley (the counties of Fresno, Kern, Kings, Madera, Merced, San Joaquin, Stanislaus and Tulare) is well below the recommended level for primary care and specialists.

While 38% of the state’s population is Latino, only 4% of MDs are. This underrepresentation is particularly pronounced in the Valley.

The total number of MDs in the state (92,000 in 2011) does not accurately reflect their ability to provide care – about 20% of them devote less than 20 hours a week to patient care. Half devoted 40 hours a week or more to patient care. Time is also spent on research, administration and teaching.

More than 30% were older than age 60. Only New Mexico has a higher proportion in this age group.

There were more than 300,000 actively licensed registered nurses in California in 2012, the single largest health profession in the state. But the RN-per-capita ratio is significantly lower than the national average.

Latinos were significantly underrepresented among RNs while Filipinos and whites were significantly overrepresented. About one in five RNs were trained outside the U.S.

There were nearly 30,000 actively practicing California dentists in 2012 -- about 23% nearing retirement with 30 or more years of practice. Female dentists were 30%, and many newly licensed were female. Only 8% of female dentists were nearing retirement.

More dentists have become specialists -- the pay is way better.

The supply of dentists varies by region with the Bay area having the highest dentist-to-population ration (5.1 per 5,000 population) while the Valley had the lowest (2.4).

A few years back, then-U.S. Rep. George Radanovich would bristle when someone labeled the Valley as “Appalachia West.” We need to bristle with enough indignation, innovation and energy to lure those who are comfortable dealing with massive challenges and who have the resources (the Bill and Melinda Gates Foundation, for example, which has tackled preventable diseases among many other things).

We need to move from being a sad laboratory to a case study in successful turnaround.

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